Prognosis

The temporal course of a neuropathy varies widely based on the etiology. With trauma or ischemia, the onset is acute, with maximum symptoms at onset. Inflammatory and some metabolic neuropathies have a subacute course extending over days to weeks. A more chronic course over weeks to months is the hallmark of most toxic and metabolic neuropathies. The very slowly progressive neuropathy over many years is the usual pattern of hereditary neuropathies or of chronic inflammatory demyelinating polyneuropathy.

• Sensory Neuropathic Damage - This is when some parts of your body lose all sensation. For example the loss of feeling in the hands or feet. Some parts of the body become hypersensitive and you wake up in the night screaming as you receive random pain signals from every nerve in your body. Sensory neuropathy is by far the most common manifestation of alcoholic neurological dysfunction. This is manifested by poor peripheral sensation and occasionally neuropathic pain - which is more common in diabetics and people with multiple sclerosis than in alcoholic peripheral neuropathy.
• Autonomic Neuropathic Damage - This is when you can't feel when you need to go to the loo and you can't feel if you've already let it go. Alcoholics do not tend to get autonomic neuropathies, certainly not as commonly as say diabetics. Loss of bladder function is one manifestation of autonomic neuropathies but this is usually not being able to pass urine rather than being incontinent. Others are a fall in blood pressure on standing and a fast heart rate. A condition alcoholics can get is Wernicke-Korsakoff disease due to vitamin B1 deficiency and heavy alcohol abuse which leads to ataxia (poor co-ordination and unsteady walking) and dementia.
• Motoric Neuropathic Damage - You're practically paralysed and can't do anything at all. Your mouth has problems with speaking, people have difficulty understanding what you're saying and muscles think they receive signals from your brain and start to move uncontrollably. Motor neuropathies do not tend to involve the muscles of the face but often involve muscles of the extremities, with decreased power making walking difficult and also decrease in proprioception². Uncontrollable muscle movement is not characteristic of alcoholic neuropathy and occurs with primary brain lesions.